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1.
Medicina (Kaunas) ; 58(2)2022 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-35208522

RESUMO

Background and Objectives: Sarcomas are rare malignant tumors of mesenchymal origin. Their low prevalence and histological heterogeneity make their diagnosis a challenging task. To the best of our knowledge, the epidemiology of soft tissue sarcomas (STSs) was not well studied in Jordan. This study thus aimed to determine STS epidemiologic trends at King Abdullah University Hospital (KAUH); a tertiary hospital that provides cancer healthcare for 70% of the population in Irbid Governorate, North Jordan. The findings of this study will provide a good reference point of the burden of STSs in Jordan and the Middle East region. Materials and Methods: All cases with confirmed STS diagnoses who attended KAUH from January 2003 until December 2018 were included in the initial analysis. Bone sarcomas, gastrointestinal stromal tumors and uterine sarcomas were not included in the study. Information collected from the pathology reports and electronic medical records was used to determine STS prevalence, incidence rate, age and gender distributions, histological types and anatomic location. Cases were reviewed by three pathologists with interest in soft tissue tumors. The findings were compared with literature. Results: In total, 157 STS cases were reported (1.9% of cancers diagnosed at KAUH during the 16-year study period). Crude annual incidence rate (IR) per 100,000 person-years ranged from 0.48 in 2015 to 1.83 in 2011 (average = 1.04). Age-standardized IR (ASR)(World WHO 2000-2025) was 1.37. Male:female ratio was 1.3:1. Median age was 39 years. Age ranged from <1 year to 90 years. Overall STS rates increased with age. The most common histological types were liposarcoma (19%), rhabdomyosarcoma (17%) and leiomyosarcoma (10%). The most common anatomic location was the extremity (40.1%), followed by the trunk (14.7%), then head and neck (10.8%). Conclusion: STSs are rare in North Jordan. A slight increase in their incidence was identified during the study period similar to global trends. The collection of relevant data on established risk factors along with a broader scale evaluation of the epidemiology of STS in the Middle East region is recommended to better evaluate disease burden and trends.


Assuntos
Sarcoma , Neoplasias de Tecidos Moles , Adulto , Feminino , Humanos , Incidência , Lactente , Jordânia/epidemiologia , Masculino , Sarcoma/epidemiologia , Neoplasias de Tecidos Moles/epidemiologia , Centros de Atenção Terciária
2.
Eur J Orthop Surg Traumatol ; 30(2): 351-358, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31542823

RESUMO

INTRODUCTION: Closed femoral-shortening osteotomy over an intramedullary nail for the treatment of leg length discrepancy (LLD) is a demanding surgical technique, classically requiring specialized instrumentation (intramedullary saw and chisel). Herein, we describe our experience with shortening osteotomy over a nail, using a percutaneous multiple drill-hole osteotomy technique to perform the bone section with the osteotomized bone smashed and let on-site. METHOD: We operated on six patients with LLD due to: hemihypertrophy syndrome (three patients), congenital short femur, hemiplegic cerebral palsy, and growth plate injury. Mean femoral shortening was 4.2 cm. Osteotomy was performed via a multiple drill-hole technique, and femurs were stabilized using an intramedullary nail. Post-operative clinical and radiological data were recorded. Residual LLD was assessed through long-standing teleroentgenography. RESULTS: Shortening was achieved, with a final LLD of < 1 cm in all patients. All patients were satisfied and considered the lengths of the lower limbs to be equal. Our technique did not require special surgical skill or specialized instrumentation. Moreover, we did not record intraoperative and post-operative complications. DISCUSSION: Percutaneous femoral-shortening osteotomy over a nail using the on-site smashing osteotomy technique was effective and safe in treating LLD in this initial case series.


Assuntos
Pinos Ortopédicos , Fêmur/cirurgia , Desigualdade de Membros Inferiores/cirurgia , Osteotomia/métodos , Adolescente , Adulto , Feminino , Fêmur/diagnóstico por imagem , Humanos , Masculino , Osteotomia/instrumentação , Radiografia , Resultado do Tratamento , Adulto Jovem
3.
Int Orthop ; 43(11): 2601-2605, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-30645687

RESUMO

PURPOSE: Stump overgrowth is the main problem of limb amputation in children. Many surgical procedures have been developed to overcome the problem, but all have shown inconsistent results. The only surgical procedure that has been successful in preventing overgrowth is capping of the amputated limb with a cartilaginous cap taken from the amputated limb, usually from the head of fibula. A donor site is not available in revision cases. Iliac crest apophysis transfer was suggested to treat the condition, but has never been previously reported. The purpose of this study is to review the results of iliac crest apophysis transfer to prevent stump overgrowth. METHOD: Five children with amputation stump overgrowth underwent iliac apophyseal transfer to cap the resection site of the overgrowth. RESULTS: Retrospective review showed that three of the five suffered recurrent stump overgrowth two to four years after the index surgery. All three were revised again. One patient was lost to follow-up. CONCLUSION: Although many studies showed capping of the stump with cartilaginous cap to be successful in preventing stump overgrowth, iliac crest apophysis transfer was only successful in one of four cases available to follow-up (25%). This is not a reliable enough method to be used routinely.


Assuntos
Cotos de Amputação/cirurgia , Amputação Cirúrgica/efeitos adversos , Cartilagem/transplante , Ílio/transplante , Ossificação Heterotópica/cirurgia , Cotos de Amputação/diagnóstico por imagem , Transplante Ósseo/métodos , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Ossificação Heterotópica/diagnóstico por imagem , Ossificação Heterotópica/etiologia , Reoperação , Estudos Retrospectivos , Falha de Tratamento , Resultado do Tratamento
4.
Eur J Orthop Surg Traumatol ; 29(6): 1355-1358, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30968204

RESUMO

Epidermoid cysts are asymptomatic, slowly enlarging, firm to fluctuant, dome-shaped lesions. Epidermoid cysts frequently appear on the trunk, neck, face, and scrotum, behind the ears and in the palmoplantar region. We review all the cases of epidermoid cyst of the knee and present a case of non-traumatic-induced epidermal cyst in the popliteal fossa of a 66-year-old male with 10-year history of right knee swelling, which appeared firstly as a small mass 2 × 2 cm in the popliteal aspect of the knee. The mass was increasing gradually in size until 2 years ago when it increased suddenly to gain the dimensions of 4 × 6 cm. MRI of the right knee revealed a well-defined cystic lesion in the subcutaneous tissue measuring about 7 × 5 × 5 cm containing internal debris and septations. He underwent complete surgical excision of the mass. The pathological results revealed an epidermal inclusion cyst. To the best of our knowledge, this is the second description for epidermal inclusion cyst involving the popliteal fossa. We were able to retrieve three cases of epidermal cyst of the knee from the literature since its first description in 2004. Including our case, we had a total of four cases of epidermal cyst of the knee. Three males and one female constituted the patients' sample. The mean age for the patients is 55. The epidermal cyst occurred equally in both knees. The popliteal fossa was the location for two epidermal cysts. Similarly, the prepatellar region was the location for another two cysts.


Assuntos
Artroscopia/métodos , Cisto Epidérmico , Artropatias , Articulação do Joelho/diagnóstico por imagem , Idoso , Cisto Epidérmico/diagnóstico por imagem , Cisto Epidérmico/patologia , Cisto Epidérmico/fisiopatologia , Cisto Epidérmico/cirurgia , Humanos , Artropatias/diagnóstico , Artropatias/patologia , Artropatias/fisiopatologia , Artropatias/cirurgia , Imageamento por Ressonância Magnética/métodos , Masculino , Resultado do Tratamento
5.
JBJS Case Connect ; 14(2)2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38758833

RESUMO

CASE: We report a case of a 3-year-old girl who developed a post-infectious femoral neck pseudoarthrosis after a proximal hematogenous femoral osteomyelitis (type 3 according to Hunka classification of the sequelae of the septic hip in children). The patient was treated by a modified "SUPERhip 2" procedure (a reconstructive procedure described to reconstruct congenital femoral neck pseudoarthrosis). This report describes the surgical technique in details and discusses the advantages, pitfalls, and complications and possible complications. CONCLUSION: Our modification simplifies the "SUPERhip 2" procedure. Postinfectious neck pseudoarthrosis was successfully treated, and we believe this modification is applicable for the treatment of congenital femoral neck pseudoarthrosis as well.


Assuntos
Colo do Fêmur , Pseudoartrose , Humanos , Feminino , Pseudoartrose/cirurgia , Pseudoartrose/etiologia , Pseudoartrose/diagnóstico por imagem , Pré-Escolar , Colo do Fêmur/cirurgia , Colo do Fêmur/diagnóstico por imagem , Osteomielite/cirurgia , Osteomielite/etiologia , Osteomielite/diagnóstico por imagem
6.
SICOT J ; 9: 6, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36853143

RESUMO

Pediatric acetabular dysplasia is common in orthopedic practice. Femoral de-rotational varus osteotomy (FDVO) is one of the surgical options suggested for treatment. In this article, we describe a simplified surgical technique of performing FDVO percutaneously using a pediatric Limb Reconstruction System external fixator, and we discuss the advantages and disadvantages of the technique.

7.
Am J Case Rep ; 22: e928592, 2021 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-33602891

RESUMO

BACKGROUND Brucellosis is a major health problem, especially in endemic countries. Although musculoskeletal system involvement is common with brucellosis, the development of septic arthritis in connection with brucellosis has been rarely reported. CASE REPORT A 7-year-old girl presented with high-grade fever and severe right hip pain. Based on her clinical picture, laboratory tests, and radiographic images, septic arthritis was diagnosed and subsequently managed with standard septic arthritis treatment. The severity of hip pain significantly decreased after hip drainage. However, a high-grade fever persisted, raising suspicion of brucellosis, which was confirmed by serological testing. Standard treatment of brucellosis was administered and the patient responded well. CONCLUSIONS Brucella arthritis should be considered as a differential diagnosis of septic hip, especially in endemic areas. The nonpurulent nature of the hip aspirate should raise suspicion of brucella arthritis. Early diagnosis of brucella septic arthritis is important to avoid serious complications.


Assuntos
Artrite Infecciosa , Brucella , Brucelose , Artrite Infecciosa/diagnóstico , Brucelose/complicações , Brucelose/diagnóstico , Brucelose/tratamento farmacológico , Criança , Diagnóstico Diferencial , Feminino , Quadril , Humanos
8.
J Epidemiol Glob Health ; 11(1): 132-136, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33605114

RESUMO

OBJECTIVE: Primary tumors of bone are relatively uncommon. Little information is available about the etiology, pathophysiology, risk factors and epidemiologic features of bone tumors. In this article, we present the epidemiological data about the primary (benign and malignant) bone tumors in Jordan. METHODS: Retrospectively, we identified and assessed those patients who were diagnosed with primary bone tumor between January 2004 and December 2018 at King Abdullah University Hospital. The following information was obtained: demographics (age, sex), clinical presentation, and location of the tumor. Also, the histopathological results and finding and recurrence of the tumors were retrieved. The included primary bone tumors were those tumors fulfill the World Health Organization classification of soft tissue and bone tumors. RESULTS: During the study period, four-hundred and thirty-seven cases of the primary bone tumor were diagnosed in our institution. More than half of the cases were males (52.5% males and 47.5% females). In most cases, young adults are affected. The mean age for the diagnosis of giant cell tumor of bone (GCTB) is 34.1 years. The appendicular skeleton was involved in 269 (81.5%) patients while the axial skeleton in 60 patients. The most common encountered pathology is the multiple myeloma with 120 patients. After that, osteochondroma was diagnosed in 110 patients. Females were mostly affected by giant cell tumor while the osteochondroma and chondrosarcoma were seen mostly in males. Multiple myeloma tends to develop in elderly while juvenile ossifying fibroma occurred in young pediatrics and Ewing sarcoma in school-age children and adolescents. Giant cell tumor and osteoid osteoma have the tendency to recur. CONCLUSION: The diagnosis of primary bone tumors is of particular important. The reporting of epidemiological studies is essential in order to expand our knowledge regarding this uncommon type of tumors.


Assuntos
Neoplasias Ósseas , Tumor de Células Gigantes do Osso , Adulto , Neoplasias Ósseas/epidemiologia , Feminino , Tumor de Células Gigantes do Osso/epidemiologia , Humanos , Jordânia/epidemiologia , Masculino , Estudos Retrospectivos
9.
Am J Case Rep ; 19: 426-430, 2018 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-29636441

RESUMO

BACKGROUND Congenital pseudoarthrosis of the tibia is one of the most difficult orthopedic diseases to treat. Many authors consider osteotomy of the bowed non-broken tibia a contraindication. However, leaving the patient with a deformed, bowed leg is intolerable and is associated with deformity progression and increased risk of fracture. CASE REPORT A 12-year-old boy presented with a bowed leg. X-ray tibia showed partially healed congenital pseudoarthrosis of the tibia and 30 degrees of flexion deformity. Deformity was successfully treated by percutaneous osteotomy made through the site of congenital pseudoarthrosis and gradual correction using a computer-assisted external fixator, the Taylor spatial frame (TSF; Smith and Nephew, Memphis, TN). At the end of the correction, a telescopic Fassier-Duval intramedullary nail was used prophylactically to prevent re-fracture. After 2 years of follow-up, X-ray images show bone-healing without any bowing. CONCLUSIONS Closed percutaneous osteotomy, without excision of the pseudoarthrosis, and gradual correction then insertion of Fassier-Duval telescopic nail may serve as a treatment to correct deformed bone in congenital pseudoarthrosis of the tibia.


Assuntos
Pinos Ortopédicos , Fixadores Externos , Procedimentos Ortopédicos/instrumentação , Osteotomia/métodos , Pseudoartrose/congênito , Tíbia/anormalidades , Criança , Humanos , Masculino , Pseudoartrose/diagnóstico , Pseudoartrose/cirurgia , Radiografia , Tíbia/diagnóstico por imagem , Tíbia/cirurgia
10.
J Clin Med ; 7(4)2018 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-29649099

RESUMO

Pertrochanteric femur fractures are considered amongst the most commonly encountered fractures in the geriatric age group. We evaluated radiographic and functional outcomes of patients with unstable pertrochanteric fractures treated with the proximal femur nail antirotation (PFNA). Between March 2013 and December 2015, fifty patients (28 male and 22 females with a mean age of 72.8 years (range, 20-94)) with unstable pertrochanteric fractures (AO 31.A2 and 31.A3) were fixed with the PFNA at our institution, and they were retrospectively evaluated. Forty one patients were treated with short PFNA and nine with long PFNA. Operative time ranged between 30 and 150 (average 73.60) min, blood loss ranged between 50 and 250 (average 80) milliliter and hospital stay ranged between 3 and 18 (6.86) days. The mean follow-up period was 18 months (range, 11-31). At final follow-up, solid union of all fractures had been achieved without any implant-related complications, the mean Harris Hip Score (HHS) was 79.34 ± 9.10 points and the mean neck-shaft angle was 127.2° ± 5.07°. No significant differences were encountered between the functional and radiographic outcomes of the PFNA with regards to the AO fracture classification and the implant version. PFNA is a recommended option for the treatment of unstable pertrochanteric fractures owing to its easy insertion, reduced blood loss, stable fixation and satisfactory functional and radiological outcomes.

11.
Artigo em Inglês | MEDLINE | ID: mdl-28050604

RESUMO

BACKGROUND: This was a prospective study to evaluate the effect of multilevel vertebral augmentation in addition to conventional therapy in multiple myeloma patients. METHODS: We treated 27 patients, whom were recently diagnosed to have multiple myeloma by two ways of treatment. Thirteen patients (group I) were treated with conventional therapy and 14 patients (group II) with adding vertebroplasty and kyphoplasty. Patients were evaluated pre-treatment and at half, one, two and 3-years post-treatment by using Oswestry Disability Index (ODI), the Stanford Score (SS) and the Spinal Instability Neoplastic Score (SINS). RESULTS: Mean values of ODI, SS and SINS were 31.9 (63.8%), 4.3 and 13.8 for group I and 33.2 (66.4%), 4.6 and 12.8 for group II before starting treatment. Group II showed improvement better than group I at all follow-up intervals with best results at first 6 months. P-values at the end of the study were ODI = 0.047, SS = 0.180 and SINS = 0.002. Mortality rates were equal of both groups (four patients of each group). CONCLUSION: Adding vertebral augmentation to conventional therapy improves multiple myeloma patients' quality of life, but didn't affect the mortality rate.

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